A Canadian claimant may be eligible for title II disability benefits if he or she:
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•
meets disability insured status based on U.S. work; or
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•
meets disability insured status requirements based on combined U.S. quarters of coverage (minimum 6 Social Security quarters of coverage (SSQCs)
and Canadian (either Canada or Quebec) work credits as described in GN 01702.410 Routing of Claims for U.S. Totalizaiton Disability Benefits.
After determining the claimant’s insured status, follow the steps in the table below.
NOTE: If a non-border field office (FO) receives, a claim filed by a Canadian resident,
forward the claim to the Office of International Operations for a medical disability
determination.
Number Holder Status
|
Border FO Action
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If the number holder meets disability insured status based on U.S. work
|
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•
Transfer the claim to the DDS based on proposed date last insured (DLI) based on U.S.
quarters of coverage (QCs) alone; and
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•
Continue to develop the non-medical aspects of the claim simultaneously with the DDS
medical development.
|
If the number holder meets disability insured status based on combined U.S. (6 SSQCs)
and Canadian or Quebec work credits,
|
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•
Reload Modernized Claims System (MCS) claim;
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•
Transfer the medical portion of the claim to the DDS with the proposed DLI based on
Totalization insured status; and
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•
Continue to develop the non-medical aspects of the claim simultaneously with the DDS
medical development
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If the number holder has less than 6 SSQCs,
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•
Do not develop medical evidence;
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•
Process a 090 denial; and
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•
Forward the claim to OIO PC8.
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If the number holder has at least 6 SSQCs but does not meet disability insured status
when the alleged work (Canadian or Quebec) is considered
|
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•
Process a 090 denial; and
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•
Forward the claim to OIO PC8.
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NOTE: The border FO verifies Canadian work credits. If the claimant meets Totalization
insured status, the FO forwards the claim to the DDS for a medical determination.